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    v1.0.28
    OpenPayerBilling CodesDrugs Administered Other than Oral MethodHCPCS hcpcs-j0270-alprostadil-injection-1-25-mcg-office-administered
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    HCPCS Level II J0270: Alprostadil Injection 1.25 mcg

    HCPCS Level II code J0270 describes a 1.25 mcg injection of alprostadil administered under direct physician supervision; the service is an injectable pharmacologic treatment typically provided in an office or outpatient clinical setting where a clinician or supervising physician administers the drug rather than patient self-administration, and billing reflects the single-unit drug supply for that administration.

    For related coverage guidance, see recent payer policy updates: Epithelial Cell Cytology in Breast Cancer Risk Assessment, B-Hemolytic Streptococcus Testing, Human Immunodeficiency Virus (HIV) — Coverage Criteria for Testing and Resistance Assays.

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    Clinical & Coding Specifications

    Clinical Context

    A male patient with erectile dysfunction refractory to oral therapies presents to a urology clinic for intracavernosal injection therapy. The clinician prepares J0270 (alprostadil, 1.25 mcg) for administration under direct physician or supervising clinician observation. The encounter typically occurs in an outpatient clinic procedure room or ambulatory surgery center where the patient is positioned supine, the penis cleansed with antiseptic, and the clinician or trained nurse draws the medication into a syringe. The injection is administered into the corpora cavernosa, the patient is observed for immediate adverse events (pain, priapism, bleeding, dizziness), and post-injection monitoring continues until stable. Education is provided about potential delayed adverse events and return precautions. Documentation includes indication, informed consent, drug name and NDC if required, dosage (1.25 mcg per J0270), route (intracavernosal), supervising provider, and start/stop times for observation. This code is not used for self-administered therapy in home settings for Medicare billing because J0270 is reportable when the drug is administered under direct physician supervision in an institutional or clinic setting.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    54050Circumcision, neonatal not applicable — placeholderData not available in the input.
    54055Removal of penile implant components — placeholderData not available in the input.
    51702Bladder catheterization, simple (eg, for urinary retention)May be performed before or after procedure if urinary retention or bladder drainage is required in the peri-procedural period.
    51741Complex urethral catheterization, with irrigation and/or instillationMay be used if urinary management is necessary for a complication or coexisting condition.
    99501Home visit for injection — placeholderData not available in the input.

    Note: Related CPT code details beyond those provided in the input are limited. For the clinically related workflow, facility or clinic visit codes (evaluation and management codes) and procedure-specific penile or urology codes are commonly used alongside medication administration documentation.

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    77Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    208000000XPediatrics PhysicianA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
    207Q00000XFamily Medicine PhysicianFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
    363L00000XNurse Practitioner(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
    367A00000XAdvanced Practice MidwifeAdvanced practice midwifery encompasses the independent provision of care during pregnancy, childbirth, and the postpartum period; sexual and reproduc…
    225XP0019XPhysical Rehabilitation Occupational TherapistOccupational therapists are experts at helping people lead as independent a life as possible. Occupational therapists bring an understanding of the p…
    261QM1300XMulti-Specialty Clinic/CenterAmbulatory Health Care Facilities · Clinic/Center
    207VE0102XReproductive Endocrinology PhysicianAn obstetrician/gynecologist who is capable of managing complex problems relating to reproductive endocrinology and infertility.
    103TB0200XCognitive & Behavioral PsychologistA psychologist who reflects an experimental-clinical approach distinguished by use of principles of human learning and development and theories of cog…

    Related ICD-10-CM Codes

    25 rows

    ICD-10-CM CodeDescription
    E29.1Testicular hypofunction
    E29.8Other testicular dysfunction
    E29.9Testicular dysfunction, unspecified
    F45.41Pain disorder exclusively related to psychological factors
    F52.21Male erectile disorder
    F52.22Female sexual arousal disorder
    F63.9Impulse disorder, unspecified
    G47.33Obstructive sleep apnea (adult) (pediatric)
    I83.90Asymptomatic varicose veins of unspecified lower extremity
    N40.0Benign prostatic hyperplasia without lower urinary tract symptoms

    Showing 1–10 of 25

    Related Payer Policy Updates

    Specialty: Hematology/Oncology1 / 3

    1 rows

    PolicyPayerEffective Date
    Epithelial Cell Cytology in Breast Cancer Risk AssessmentOscar Health2026-10-01

    Related Codes

    HCPCS-J0013-ESKETAMINE-NASAL-SPRAY-1MG

    HCPCS Level II J0013: Esketamine Nasal Spray, 1 mg

    HCPCS-J0120-INJECTION-TETRACYCLINE-250MG

    HCPCS Level II J0120: Injection, Tetracycline, up to 250 mg

    HCPCS-J0121-OMADACYCLINE-INJECTION-1MG

    HCPCS Level II J0121: Omadacycline Injection, 1 mg

    HCPCS-J0122-ERAVACYCLINE-INJECTION-1MG

    HCPCS Level II J0122: Injection, eravacycline, 1 mg

    HCPCS-J0129-ABATACEPT-INJECTION-10MG-PHYSICIAN-SUPERVISED

    HCPCS Level II J0129: Abatacept Injection, 10 mg

    HCPCS-J0130-INJECTION-ABCIXIMAB-10MG

    HCPCS Level II J0130: Injection abciximab, 10 mg

    HCPCS-J0131-INJECTION-ACETAMINOPHEN-10MG-PARENTERAL-ANALGESIC

    HCPCS Level II J0131: Injection, Acetaminophen 10 mg

    HCPCS-J0132-INJECTION-ACETYLCYSTEINE-100MG-INJECTABLE-MEDICATION

    HCPCS Level II J0132: Injection, Acetylcysteine 100 mg

    HCPCS-J0133-ACYCLOVIR-INJECTION-5MG

    HCPCS Level II J0133: Injection, Acyclovir 5 mg

    HCPCS-J0134-ACETAMINOPHEN-INJECTION-FRESENIUS-KABI-10MG

    HCPCS Level II J0134: Injection, Acetaminophen (10 mg)

    Showing 1–10 of 991

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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